It is NOT an artificial pancreas

My rant…

The media has been shouting for a while now about the new “artificial pancreas” on the market.  This is driving me crazy.  It is not an artificial pancreas. It is a new insulin pump.  This new pump has some automated features but it does not completely replace a pancreas that is not producing insulin. It does not bolus for food on its own.  It is not a cure. What this new device is is a new device! It is another tool to help people living with diabetes live a better life.  That is it!

Medtronic® does not call their latest insulin pump an artificial pancreas. They simply refer to it as “The world’s first self-adjusting insulin pump system for people with type 1 diabetes” (over 7 years of age).  That is fair.

In auto-mode, this new pump will make adjustments and suspend itself.  It uses information from the continuous glucose monitor (CGM) to predict rises and falls in blood glucose levels. The 670G (this self-adjusting insulin pump) will get your background insulin (your basal rate) under control for you.  In turn, “the sensor must be calibrated at a minimum of every 12 hours throughout the life of the sensor. For better sensor performance, it is recommended that you calibrate your sensor three or four times each day.” (page 216 of users manual).  The manual also notes that “the Auto Mode feature still requires your input for meals, calibrations, and times when you need the target value raised.” (page 231).  Again, making this is not a true “artificial pancreas” but a new tool for people with insulin-dependent diabetes.

not an artificial pancreas
It’s just a new tool!

This is great! I am seriously all for better tools.  I am also all for choice as you can read here and here.  I even have developed a tool to help you make your own choices when it comes to purchasing an insulin pump here.

Choice is vital because everyone’s diabetes is different. Children have different needs from teens. Teens have different needs from adults. One adult requires different things from an insulin pump than another does. The good news though is that more choice is coming…or in some countries it is already here.

insulin pumps

In the US, besides the Medtronic® 670G, you have the option to use the t:slim X2™ with Basal IQ™ (this option is available in countries where the t:slim X2™ is sold and the Dexcom® G6 is approved for use). This pump also has a great automated feature. 

It predicts low blood glucose levels ahead of time and stops insulin delivery.  The Basal IQ™ technology will allow the insulin pump to turn insulin delivery on and off as often as every 5 minutes.  As I noted, this system works with the Dexcom® G6 Continuous Glucose Monitor which is currently the only CGM approved for use without the need for fingerstick calibration.  

These systems have been approved for use in the US and other countries. There are other projects that are still being tested like the iLet® project out of the University of Boston.  Bigfoot Biomedical® is working on some exciting projects and patients are creating their own closed loop in the #WeAreNotWaiting projects.

The world of diabetes management tools is once again expanding at a fascinating rate. It is an exciting time.

We are not however at a time when diabetes is cured with an artificial pancreas.  No system counts carbs—although the ILet potentially will allow the pump to learn how. Every system requires you to change out infusion sets that can kink or come out of the body.  All of these systems require learning on the part of the user and the machine. 

Perhaps in another 20 years, we will see a true artificial pancreas.  Maybe in another 30 years, it will be available to everyone who needs one.  In the meantime, people with diabetes must continue to educate themselves on the various features of insulin pumps and choose the pump that best fits their lifestyle.

Download our ebook to help you find the right insulin pump for you.

Tides of Hope

Artificial Pancreas approved by FDA”  Sounds great doesn’t it? Its sadly right up there with “Scientists find way to cure diabetes”…in mice.  Well, its not quite that bad but it is media hype that does not quite match the reality of the innovation.

The Medtronic Veo insulin pump has been available in Canada for quite some time.  For a change, we were able to avail of a new technology before the US market. In this case, it means availing of a technology that shuts down your insulin pump if your CGM tells the pump that you are low and dropping. This is a pretty great feature but does not for many equate to a true “artificial pancreas”.

A number of people in the diabetes community feel that a true artificial pancreas is more in keeping with Dr. Ed Damiano’s Bionic Pancreas project rather than these smarter pumps. His pro-type has been used on adults and children with Type 1 diabetes in real world settings. A bulky model at that moment, but it has given people with Type 1 diabetes a freedom that they have not experienced since prior to their diagnosis.

Dr. Damiano’s approach combines the use of insulin, glucagon, a CGM, a smart insulin pump, and finally an iPhone.  With all of this, he is able to create a pancreas for people like his son who live with Type 1.  Those who have listened to his presentation (like myself) walk away amazed and inspired. Those who have used the system talk of an experience like nothing that they have ever imagined before.  They were able to enjoy meals without carb counting. They had nights without testing.  They experienced relatively stable bg levels. It is truly amazing.

This research is not funded by an insulin pump company. This researched is fueled by a father’s desire to keep his son safe.  David Damiano was diagnosed with Type 1 diabetes at the age of 11 months. This amazing project has given my own son hope where he didn’t have a lot before.

There are many great changes in the wind for people living with diabetes. Whether we are looking at a bionic pancreas, an artificial pancreas, or simply the improved accuracy of Continuous Glucose Monitoring systems.  Diabetes care has moved forward a lot since our journey began over 13 years ago. I am excited to see it move forward much further in the next 13! The next challenge will be to ensure that people living with diabetes will have the ability to access these improved technologies.

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